Fig. 2
Spine plots showing agreement between claims-based methods for sepsis identification and abstracted clinical criteria (N = 2217). Legend: Total N = 2217 adjudicated hospitalizations. Implicit/Explicit ICD-9 sepsis defined based on taxonomies of infection and organ dysfunction codes proposed by Angus, et al. in addition to explicit sepsis codes. CMS ICD-9 sepsis defined based on list of codes used in the CMS measure. REGARDS-EHR defined as infection event meeting modified EHR criteria proposed by Rhee, et al.4 REGARDS-SOFA defined as infection event with ≥2 SOFA points across all organ systems (respiratory, cardiovascular, renal, hematological, hepatic, and neurological). REGARDS-qSOFA defined as infection events meeting ≥2 qSOFA criteria. Light blue cells indicate events with REGARDS and without Medicare. Light red cells indicate events without REGARDS and with Medicare. Panels A-C) Concordance between Medicare-Implicit/Explicit and abstracted clinical criteria (REGARDS-SOFA, REGARDS-qSOFA, and REGARDS-EHR). Panels D-F) Concordance between Medicare-CMS and abstracted clinical criteria (REGARDS-SOFA, REGARDS-qSOFA, and REGARDS-EHR). Rectangle areas represent cell proportions. Cell percentages shown in rectangles or next to arrows. SOFA = sepsis-related organ failure assessment; qSOFA = “quick” sepsis-related organ failure assessment; EHR = electronic health record. CMS = Centers for Medicare and Medicaid Services; ICD-9 = International Classification of Diseases, Ninth Revision